Radiothérapie conformationnelle des cancers de la prostate: Revue générale

Summary progress in radiotherapeutic management of localized prostate cancer is reviewed. Clinical aspects —including dose-effect beyond 70 Gy, relative role of conformal radiation therapy techniques and of early hormonal treatment —are discussed as well as technical components —including patient immobilization, organ motion, prostate contouring, beam arrangement, 3-D treatment planning and portal imaging. The local control and biological relapse-free survival rates appear to be improved by high dose conformal radiotherapy from 20 to 30% for patients with intermediate and high risk of relapse. A benefit of overall survival is expected but not yet demonstrated. Late reactions, especially the rectal toxicity, remain moderate despite the dose escalation. However, conformal radiotherapy demands a high precision at all steps of the procedure.